miraDry Forum

Electromagnetic (Microwave/miraDry, Radiofrequency, Laser) and Ultrasound based Hyperhidrosis Treatments

As of 2014, all of the below are almost exclusively used to treat armpit sweating. Some doctors and researchers are experimenting using the below technologies to treat excessive hand and feet sweating treatment, but I would not risk being a guinea pig till more results and studies come out. The skin on your palms and soles is a lot thicker than in the armpit region, and the palms and soles both have far more sweat glands than the armpits.

  1. miraDry Electromagentic Therapy for Underarm Sweating

  2. The relatively new miraDry nonsurgical electromagnetic (microwave) radiation therapy received FDA clearance in 2011, EU CE Mark approval in 2013 and Chinese government approval in 2015. The below two embedded youtube videos summarizes the technology. It seems like most people will need two treatments over three months, and will end up with around 80-90 percent less sweat at the end. Average cost of treatment is $3,000, and a treatment consists of two 1 hour sessions spread across 3 months. Although many patients only need one session, a lot of clinics will still charge the full $3,000 upfront. You should try to go to a clinic that charges you $1,500 per session.

    There are around 20,000-30,000 sweat glands in an average armpit, a negligible fraction of the two million or so sweat glands in the body. Numbers do vary somewhat depending on race, sex and body size. However, overall, this seems to indicate that eliminating such a small portion of the body's total sweat glands will not affect the body's ability to control overheating or result in any significant compensatory sweating.

    According to Miramar, during treatment, the energy delivered to an average size underarm is around 4,000 joules. In comparison, 80,000 joules is required to boil eight ounces of room temperature water. During treatment, local anesthetic (usually lidocaine) is used to numb the armpits to prevent any significant pain. The number of injections will vary depending on size of area being treated and a person's sex and total weight. It seems like 20-30 injections is typical. Two other side benefits of this treatment are that it reduces armpit hair and armpit odor significantly. For most people, both these factors are considered to be highly desirous.

    As far as I can tell, the main negative with miraDry is that the few studies on the product have been sponsored by the manufacturer (Miramar Labs) itself. It will be interesting to see if unaffiliated universities and clinics come out with their own studies on long-term miraDry results in the coming years.

    I called one of the most popular health/medical spas in my city to inquire about their miraDry results and experience. Besides their assurance of great results from treating 3-4 patients each week over the 2013-2014 two-year period, one unusual thing that I learnt was that 80 percent of their clientele was male. I was quite surprised, as I assumed it would be the reverse. One reason for this high male percentage, however, is that a lot of the people who reside in my city that are members of this spa are male due to a huge local male dominated IT industry. At the national level, the ratio might still be skewed towards females, although not by as much as I would have originally thought.

    miraDry for Hand and Feet Sweating

    Since around 2014, there have been many rumors that miraDry is being tested to treat hand and feet sweating. This was confirmed in 2016 by a poster on the hyperhidrosis forum on this site, and one guy even posted about his experience in being a test volunteer patient for miraDry hand sweating treatment trials. The hands and feet both have many times more sweat glands in comparison to the armpits, and treatment must also ensure that tendons and other important parts of hands and feet do not even get minimally damaged during the miraDry procedure. I look forward to hearing more about this new option to treat excessive hand and feet sweating in the next several years and will keep my fingers crossed for the best. If as effective as for armpit sweating, miraDry will represent a revolution in hyerhidrosis treatment.

    Important miraDry Related Links

    Interesting miraDry Related Videos

  3. SweatX Radiofrequency based Dielectric Heating

  4. SweatX is a proprietary laser treatment from Alma Lasers that claims to be able to stop regular hyperhidrosis and/or osmidrosis (also known as bromhidrosis -- aka smelly sweating). It seems like you need 4 treatments per area (price seems to be around $500 per session, so $2,000 total per area), and the results last for 9 months (but potentially much longer).

    A great overview on SweatX, including technical details.

  5. Ulthera Ultrasound Therapy

  6. A new nonsurgical ultrasound therapy called Ulthera has shown some promising results since 2011 and was undergoing FDA clinical trials in 2012 and 2013, but as of 2014, not much has been reported on the final results. If successful, this could become the most popular treatment, since ultrasound is less dangerous in comparison to electromagnetic radiation (lasers, microwave, radiofrequency etc...). It should be noted that even electromagnetic radiation is generally very safe at the lower doses that are used in treating axillary sweating, but many people and scientists are still concerned about potential long-term side effects since we are constantly exposed to so many waves these days (microwaves, GPS and cell phone signals, wifi signals, x-rays, radio waves and more).

    " Graydwarf " on the forums on this site has a super useful thread on various treatments that he has tried, and one of those is Ultherapy. See his updates to his first post from July 2014 and onwards for his experiences with Ultherapy.

  7. Cynosure PrecisionTx Laser

  8. A number of doctors have been treating hyperhidrosis using various lasers in recent years. Perhaps the most well known of these are Dr. Whiteley (LSA -- laser sweat ablation) in the UK and Dr. Nielsen (SDLA -- subdermal laser ablation) in the US. Both these doctors seem to have their own proprietary technologies and techniques. Dr. Whiteley has trained a few other doctors to use his technique.

    However, in recent years, Cynosure's PrecisionTx laser technology has garnered significant positive reviews when used to treat excessive armpit sweating, and many doctors are purchasing it, especially in the US. The unique aspect of this laser device is that after a very thin cannula with proprietary SideLaze fiber is inserted under the skin, laser energy is directed upwards towards the undersurface of the skin, targeting sweat glads and hair follicles there. This reverse counter-intuitive application of a laser limits potential damage to deeper areas underneath the skin surface as is often a risk with most other cosmetic lasers that are used on the surface of the skin rather than underneath it.

    Dr. Lindsay in Ohio has a great overview of Cynosure Precision Tx on his website.

    Video from Dr. Barbara Padilla in Connecticut:

  9. ThermiDry Radiofrequency based Treatment for Underarm Sweating

  10. A Radio Frequency based treatment that has become more popular recently. No official website link as of 2015.